Vale, Professor Michael Cousins
29 April 2024
We are saddened to hear of the passing of Professor Michael Cousins, first FPM Dean (1998-2000) and ANZCA President 2004-2006.
Michael Cousins was recognised, both locally and globally, as a giant in pain medicine and a genuine trailblazer whose work continues on in improving the lives of pain sufferers worldwide.
We spoke to a number of people about Michael Cousins’ legacy at the 2024 FPM Symposium and ANZCA Annual Scientific Meeting, which took place a few days in Brisbane a few days after Michael's death.
Born in Sydney in 1939, he studied medicine at the University of Sydney, graduating in 1963 with a MB BS in 1963. After graduating, he completed his residency at the St George Hospital and undertook training in anaesthesia at the Royal North Shore Hospital. With a natural interest in, and inclination toward research, Michael was awarded a postgraduate fellowship from the University of Sydney to carry out research on acute pain management. This gave him the opportunity work with Professor Philip Bromage, a pioneer in the field, at McGill University in Montreal, Canada.
In 1970, Michael was appointed Assistant Professor of Anesthesia at Stanford University, California. Here, he collaborated with Professor Richard Mazze in studies of the metabolism and kidney toxicity caused by inhalational anaesthetic agents. This work saw him awarded an MD by the University of Sydney. During his time in Canada and the US, he worked with three of the pioneers in pain medicine: Dr Ronald Melzack, Dr Patrick Wall, and Dr John Bonica. These interactions stimulated the research, teaching, clinical innovation and development of the field of pain medicine in Australia and internationally.
Michael returned to Australia in 1975, setting up a multidisciplinary centre in pain medicine at Flinders Medical Centre in Adelaide and, in 1990, at the University of Sydney, Royal North Shore Hospital. Both of these centres became internationally recognised for clinical care, teaching and research. In 1998, the University of Sydney Pain Management Research Institute (PMRI) was recognised by the National Health and Medical Research Council (NHMRC) of Australia as one of only eight “Centres of Clinical Excellence in Hospital Based Research”.
Michael also fostered the development of a University of Sydney diploma and masters course in pain management. He chaired a NHMRC working part between 1995 and 1999 which developed Australia’s first evidence-based medicine guideline on the management of acute pain. This guideline is now used internationally.
In 1987, Michael was appointed president of the International Association for the Study of Pain (IASP) – the first Australian, and only the second anaesthetist to hold that office. He served a three-year term and played a major role in stimulating the IASP to form an official relationship with the World Health Organisation to place more emphasis on cancer pain and acute pain, in addition to the existing emphasis on chronic pain. The first IASP core curriculum on pain was developed together with a document that first described the desirable characteristics for multidisciplinary pain centre, and a groundbreaking report on pain in the workplace.
Michael was an ANZCA councillor from 1995 through to 2006, and elected as ANZCA President in 2004. Major initiatives during his presidency include overhauling governance processes, a new focus on perioperative medicine, a new emphasis on quality and safety, involvement of prominent community leaders on the ANZCA Foundation Board, and a major research fundraising drive.
As a councillor, he was strongly involved in the development and implementation of the Faculty of Pain Medicine (FPM), the world's first multidisciplinary medical academy devoted to education and training in pain medicine. It was founded in 1998 with Michael as the inaugural dean. In these roles, he contributed to the development of health policy, which continued via his role as a councillor of the Australian Medical Council (AMC).
In this oral history video, recorded in 2017, Prof Cousins talks to then ANZCA President Prof David A ScottIn 2005, following persistent representations from FPM, pain medicine was recognised as an independent medical specialty by the AMC and in 2012 was recognised as a scope of practice by the Medical Council of New Zealand. As dean, Michael Cousins was able to work constructively with representatives of the five medical groups on the new multidisciplinary FPM Board (anaesthesia, surgery, medicine, psychiatry and rehabilitation medicine). In those years, the board developed a trainee prospectus and manual, and established committees to oversee education, training, examinations and hospital accreditation, along with a pre-examination short course and professional documents relevant to pain medicine. Since then, the faculty has trained hundreds of specialist pain medicine physicians and is now responsible for their continuing education and the standards of clinical practice for pain medicine in Australia and New Zealand.
Alongside his activities in pain medicine, Michael developed two major centres of education and research in anaesthesia via foundation chairs at Flinders University and the University of Sydney.
Michael has been the recipient of numerous awards, honours and accolades in anaesthesia and pain medicine, including being awarded an Officer of the Order of Australia in 2014. In recognition of his significant contributions to the field of pain medicine and his initiative to establish the Faculty of Pain Medicine, the faculty plenary session at the ANZCA Annual Scientific Meeting was named the Michael J Cousins Lecture. The inaugural lecture was delivered by Professor Henrik Kehlet in 2003. In 2024, the lecture will be given by Associate Professor Vivianne Tawfik, on perioperative analgesia for the patient with chronic pain.